NCMS Strategic Plan - North Carolina Medical Society · Strategic Plan’s goals, the Board has the...

NCMS Strategic Plan

May 2013

1 North Carolina Medical Society May 2013

North Carolina Medical Society STRATEGIC PLAN

MISSION STATEMENT The mission of the North Carolina Medical Society (NCMS) is to unite, serve and represent physicians in order to enhance the health of the people of North Carolina. PURPOSE The purpose of the NCMS is:

(1) To improve the quality and accessibility of healthcare, and

(2) To protect the patient-physician relationship.

(3) To promote and preserve the public’s health.

The NCMS unites physicians as the premier patient advocate in North Carolina.

STRATEGIC PLAN The NCMS Board of Directors is responsible for reviewing the Strategic Plan each year and amending it as appropriate in order to adapt to the changing environment of the practice of medicine. The Strategic Plan represents the guiding principles used to direct resources toward funding the goals and objectives of the Society. Proposed new programs that require allocation of financial support and human resources are measured based on how

they fit into the Strategic Plan. If the new programs do not meet the parameters of the Strategic Plan’s goals, the Board has the responsibility to review and amend the plan as appropriate. The NCMS membership base dictates the amount of fiscal resources available to support initiatives. AREAS OF HIGHEST PRIORITY

Assist member physicians in understanding and responding to legislative, regulatory, and other forces towards implementing positive change to the health system.

Preservation of the patient-physician relationship.

Support efforts that improve Health Care Access for all North Carolinians.

Support efforts that promote Quality of Care, Performance Improvement, and Patient Safety.

• Work to ensure equitable treatment of physicians across all specialties.

THE PATIENT-PHYSICIAN RELATIONSHIP The NCMS believes a strong patient-physician relationship is essential to good healthcare. Many studies and real-world programs have confirmed that a “medical home” facilitates healthcare of higher quality and cost-effectiveness. As healthcare


systems evolve, the NCMS will work to maintain the leadership role of the physician in healthcare. To further support the success of the patient-physician relationship, the NCMS also advocates for a healthy medical practice environment. It seeks adequate payment for services, especially for primary care. It encourages hospitals to be supportive of physicians. It cultivates public opinion that supports physicians' work through media training and public relations efforts. Also, the NCMS seeks to keep the state's regulatory burden reasonable and monitors insurance company behavior. It facilitates effective communication among physicians, helps resolve differences among physicians, and maintain strong relationships among the specialties. The NCMS provides assistance with technology, including electronic medical records.

HEALTH CARE ACCESS FOR THE UNINSURED AND UNDERINSURED The NCMS works diligently to improve access to healthcare for everyone. It supports safety net providers, strives for insurance coverage for all, and encourages physicians to practice in underserved areas. It seeks a strong public health system and supports funding for unmet health needs, such as mental health. The NCMS works to keep medication affordable to patients.

The NCMS, NCMS Foundation and member physicians are committed to ensuring both availability and access to health care for all North Carolinians. The NCMS looks to its Foundation, whose mission is to improve access to quality health care for all North Carolinians, to take a leading role in implementing these activities. The NCMS strives to develop a physician-lead, multi-payer plan to allow access to health care for all North Carolinians. The NCMS advocates at local, state and federal levels for both short-term incremental improvements and long-term fundamental changes in the complex system of financing and delivering health care. This includes the promoting and expanding voluntary care models at the community level; increasing physician participation in free clinics; expanding public programs to cover more low-income uninsured individuals; analyzing and assisting efforts to increase private sector coverage of the working uninsured. The NCMS supports the NCMS Foundation’s Community Practitioner Program, which works to recruit and retain physicians and mid-level practitioners to practice in underserved areas of the state. In working to improve the health care of all North Carolinians, it is essential to assist communities in need. The NCMS also supports Community Care of North Carolina (CCNC) and its mission of providing physician-driven, patient-centered care to make quality care more efficient and cost-effective. CCNC coordinates high-performing, regional networks of physicians, nurses, pharmacists, hospitals, health departments, social service agencies, and other community organizations, who work


together to provide cooperative, coordinated care through the “medical home” model.

ADVOCATING FOR QUALITY OF CARE, PERFORMANCE IMPROVEMENT, AND PATIENT SAFETY The NCMS supports healthcare quality initiatives, “best practices,” and continuing medical education. It protects patients by making sure the scope of practice of healthcare practitioners corresponds to their qualifications. It works to protect the ability to talk about errors and make system improvements by maintaining peer review protections and seeking liability reform. The NCMS supports adequate funding and independent authority for the North Carolina Medical Board. The NCMS evaluates and promotes health information technology to improve quality, safety, and efficiency in clinical care and practice management.

NCMS DEPARTMENTS • Government Affairs and Health

Policy • Managed Care and Practice

Management • Member Services • Specialty Society Relations • Media Relations and Public Affairs • Finance and Operations

____________________________ GOVERNMENT AFFAIRS AND HEALTH POLICY The North Carolina Medical Society advocates on behalf of physicians and their patients for quality health care in the public and private sector. Advocacy is fundamental to the NCMS mission, allowing the Medical Society to support programs and policies that enhance the health of the citizens of North Carolina. The common concerns of patients and physicians provide the foundation for our policy positions. Effective patient advocacy is fostered through NCMS participation in various activities including serving on state advisory committees, commissions and task forces. This contribution allows for ongoing input into medical policy development. The Government Affairs function is vital for setting standards in the medical community. Through extensive lobbying on state and national levels, the future of the profession can be influenced so that it best represents the goals and priorities of our members. These efforts are strengthened through ongoing NCMS PAC membership development and targeted efforts to encourage development of PACs in medical practices and medical specialty societies.

The NCMS focuses on physician education as key to success at the North Carolina General Assembly. By helping physicians understand and address legislative issues that affect them and their patients, the NCMS creates true grassroots advocacy and enhances working relationships with legislators.


The NCMS works to increase the number of physicians participating in political campaigns and the political process to ensure it can achieve legislative priorities. Legislative and advocacy issues at the forefront in North Carolina are often mirrored at the national level. The NCMS will continue to work closely with partners on the state and national levels to have a voice with the U.S. Congress including joint efforts with the American Medical Association. The NCMS legislative advocacy effort is broad and reaches into many arenas. The Society has a longstanding commitment to:

A fair system of compensation for patients injured through medical malpractice, which balances the necessity of compensation and the necessity of access to medical care,

Access to medical care for all North Carolinians through combination of public and private funding sources,

A system of laws that foster continuous improvements in the quality of medical care to the greatest extent of medical knowledge and technology,

Aggressive self-regulation of the medical profession through advocacy for adequate resources for the North Carolina Medical Board,

Regulation of the scope of practice of health professionals based upon training, experience, and expertise,

A public health system that is flexible and responsive to changing needs of our communities and that

focuses on injury and disease prevention,

Regulation of health care financing entities that is sensitive to the cost of care, but prevents substitution of cost concerns for medical concerns of the individual or for the medical judgment of physicians.

Professional Liability Reform (PLR) is a long-standing goal of our Medical Society. Our civil justice system is constantly evolving and will require a long term, flexible approach to ensure fairness and balance. This strategy will require significant resources including staff time and financial resources to attain our goal of a fairer system of identifying medical malpractice and determining compensation for injured patients. Despite enactment of reform legislation in 2011, this issue will continue to require significant resources including staff expertise and financial resources. The Finance Committee, the Board of Directors, and the House of Delegates continue to have responsibility to provide ongoing evaluation of efforts and funding needed to foster a fair tort reform system in North Carolina. Funding mechanisms will be developed and implemented at the discretion of the Board of Directors and may include but not be limited to transfers of available funds from the operating reserve, special assessments of members and/or other funding mechanisms for PLR programs. In order to optimize our private and public sector advocacy programs, the NCMS will provide support through strong legal and health policy research. We will monitor and participate in the promulgation of rules by


the NC Department of Health and Human Services, the NC Medical Board, the NC Department of Insurance, the NC Industrial Commission and other agencies to ensure that our core principles are upheld. The NCMS will advocate its views, where appropriate, through the judicial branch of government. We will work with the American Medical Association and other organizations to spread the costs. The NCMS will also work with physicians and their practices to resolve questions regarding the effect of certain state laws on their professional activities.

MANAGED CARE AND PRACTICE MANAGEMENT The NCMS provides expertise in practice management and assists physicians with payment issues including interaction with Medicare, Medicaid, and other payers. In addition, the NCMS offers various other programs to provide resources and assistance to help improve the medical practice environment.

The NCMS is a primary resource to physicians and their practices in the following areas:

Assisting practices with pending changes to the health delivery system.

Providing practical information and guidance on working with various outside organizations (managed care organizations, the NC Medical

Board, state and local medical societies and others).

Evaluating managed care master contracts by reviewing basic contract language.

Providing useful information and resources for managing the financial, legal and compliance issues associated with establishing a medical practice, vendor resources, administrative services, billing, employment issues and marketing.

Assisting with Medicaid and Medicare, including advocating for physicians on related policies with the Medicare Carrier Advisory Committee.

Providing guidance and resources for practices to ensure compliance with fraud and abuse standards. Advocating for fair and reasonable standards in this field for all payers.

Maintaining an “internal hotline” for physicians to report problems with insurance companies, managed care organizations and governmental payers that impact on the physician’s ability to deliver quality health care.

Developing educational materials and seminars to help physicians and their practices comply with changing governmental regulations.

Providing guidance on a range of physician-hospital issues (from employment contracts to Medical Staff Bylaws) and working toward improved positioning and relations.

Maintaining expertise for physicians in the regulatory arena such as Emergency Medical Treatment and Active Labor Act (EMTALA); Medicare fraud and abuse; and the Health Insurance Portability and Accountability Act (HIPAA).


Evaluating medical practice technology needs.

MEMBERSHIP DEVELOPMENT As a membership organization, the NCMS membership is the driving force behind all we do. Member involvement is key to a vital organization with a strong brand identity, which promotes the NCMS as the solution to many professional needs. Our brand is lived throughout the organization, including all member communications, external communications, publications, the website, and events. Our strategic marketing efforts reinforce the value of NCMS membership, enhance the public trust in the medical profession, motivate members to actions, and unite physicians across specialties.

Membership Growth All NCMS Programs and activities affect the medical community. As we strive to unite our members with a common voice, it is critical to include as many physicians as possible. Also, membership growth helps the organization to provide additional programs and increase the strength of our efforts with additional resources. Goals for expanding our membership base follow. Recruitment NCMS strives to build the largest membership and greatest market share in order to represent physicians statewide. To do so, the NCMS implements focused recruitment strategies targeting newly licensed

physicians, physicians moving to North Carolina, minority groups, employed physicians and academic physicians, and continually sets goals and establishes benchmarks for success. Retention Historically, the NCMS has maintained a minimum retention rate of 95 percent. This suggests that once members join, the NCMS is able to demonstrate the value of membership. To continually enhance member satisfaction and retention, the NCMS strives to maintain a consistent communication system that educates members about the value of NCMS programs and services and to identify and implement member services and programs to meet our membership’s ever-changing needs. Outreach/Retrieval of Dropped Members The NCMS works to maximize the retrieval of dropped members by conducting exit interviews, and former member outreach to communicate the value of NCMS membership.

Non-Dues Revenue The NCMS works to identify new revenue streams to decrease dependency on dues revenue and to minimize dues increases without negatively affecting the value of membership. To do so, the NCMS enters into strategic alliances with third-party vendors that provide valuable services to physicians and to medical practices. This area of activity helps us to interact with medical practice managers in order to identify practice needs, which also enhances our ability to educate medical practices as a whole about the value of NCMS membership.


SPECIALTY SOCIETY RELATIONS The NCMS strives to strengthen and expand collaborative efforts with all specialty societies, in order to enhance the Society’s efforts to unite physicians across all specialties. Partnerships with medical specialty societies provide uniformity in the positions taken and the messages conveyed to the legislature, government agencies, the NC Medical Board, the media and various state commissions, task forces, and councils on which NCMS members serve.

Management Services The NCMS provides management and administrative services to specialty societies on an annual contract basis. Services include member database management, financial management, communications production, media relations, meeting management, coordination of legislative activities, special project coordination, public and professional relations, continuing education and others. The NCMS manages the following specialty societies.

NC Dermatology Association Carolinas Chapter/American

Association of Clinical Endocrinologists

NC Society of Eye Physicians and Surgeons

NC Chapter, American College of Physicians

NC Neurological Society NC Obstetrical and Gynecological

Society NC Orthopaedic Association

NC Society of Otolaryngology and Head & Neck Surgery

NC Society of Pathologists NC Spine Society The NCMS maintains cooperative relationships with all North Carolina specialty societies including those societies who are independently managed.

MEDIA RELATIONS AND PUBLIC AFFAIRS

Communication Effective communication is essential to the NCMS advocacy efforts. There are three distinct audiences for our communications: (1)Between members and the NCMS; (2) Outreach to the medical profession as a whole, and (3) The general public and the media, which shapes public perception and opinion. As advocates for physicians and their patients, a positive image is fundamental to the NCMS. The visibility of our actions should enhance public trust in the medical profession as a whole.

Frequency of NCMS Communications NCMS communications must be reviewed and revised frequently to ensure effectiveness regarding format, content, frequency, timeliness, and delivery method. The NCMS should maintain accurate contact information for members and be able to communicate electronically and across other mediums including social media and other emerging methods.

First-Level Media The Media Relations and Public Affairs Department is the primary entity for media inquiries focused on physicians and state


medical policy. The NCMS fosters successful media relations by providing instant access to physician expertise, thus increasing visibility of Society leaders and working to ensure accurate information is available to the media and to the public. By maintaining a strong working relationship with the media, the NCMS works to be a first-level contact for print and electronic news outlets across North Carolina.

Media Support Legislative and health policy initiatives are promoted through media and press contacts, press releases and editorial board briefings. Timely editorial visitation with North Carolina newspapers provides an opportunity for the NCMS leaders to discuss issues that affect physicians and their patients while promoting appropriate public health policy.

Speaker and Leadership Training

Speaker/spokesperson training and support is available for the NCMS leadership and other interested physicians on a routine basis. The NCMS Leadership College scholars are required to attend such training. The best resource the NCMS has for communicating its messages to the media is via the NCMS membership. Helping members convey a vision or message clearly can reflect positively on the entire medical community.

Leadership College On an annual basis, a select group of “scholars” is nominated by their peers and chosen to attend the NCMS Leadership College. The Leadership

College is a collaborative project of the NCMS and NCMS Foundation, consisting of an intensive year-long, leadership development course designed to orient and train NCMS members for potential future leadership positions at the county, state and potentially the national level. The Leadership College combines the elements of mentoring, organizational education, skills training and guided experiences which cover the three “P’s” of leadership: the philosophy of leadership; the principles of leadership and the practice of leadership. While the program concentrates on leadership at the state level, the skills and principals learned will certainly benefit all of organized medicine and the profession as a whole.

FINANCE AND OPERATIONS The NCMS strives to utilize its financial resources in the most effective and efficient manner so goals can be achieved and long-term NCMS financial stability can be maintained.

Operating Reserve The NCMS strives to maintain a minimum of 15 months and a goal of 36 months of the NCMS operating budget as an operating reserve.

Prioritize Action Items The NCMS maintains a system for the Board of Directors to prioritize actions of the House of Delegates for implementation by the NCMS.

Committee and Task Force Structure The NCMS reviews the NCMS committee and task force structure annually to ensure the committees and task forces are more task-


and goal-oriented to meet the changing needs of NCMS membership.

Employee Incentives The NCMS works to maximize staff productivity, efficiency, and retention of qualified staff members by offering competitive benefits.

Society Operations The Executive Vice President, CEO works closely with the Board in assessing operations and in allocating the Society's limited human and capital resources on a regular basis. Continuous communications between the Executive Vice President, CEO, the Board of Directors, and the NCMS membership help to foster understanding of the amount of staff time and capital dedicated to each NCMS project (including House of Delegates Resolutions).

Streamlining Administration

The overall efficiency of the operations and administration of the NCMS is continuously monitored in order to ensure that all resources are maximized, including determining whether any programs or services can be performed by outside entities at a savings to the organization. This is a continuous process.

AFFILIATED ORGANIZATIONS The NCMS has an organizational relationship and governance ties to several organizations. The following organizations, because of their relationships, play an integral part in

carrying out the NCMS mission. Although all are independent organizations, some are administered under our auspices.

NC Medical Society Foundation The NCMS Foundation is a supporting organization to the NCMS. A 501(c)3, charitable non-profit, the Foundation’s mission is to improve access to quality health care for all North Carolinians, particularly for low-income, uninsured and underserved North Carolinians. Contributions to the Foundation are tax deductible. As a supporting organization, the Foundation shares leadership with the NCMS with the Society’s President, President-Elect, and Executive Vice President, CEO serving as Ex-Officio, voting members of the Foundation’s Board of Trustees. In addition, a majority of the Foundation’s Board of Trustees must be members of the Society.

NCMS PAC NCMS PAC is a non-profit, non-partisan political action committee administered by the NCMS that is organized to direct financial support from physicians to state and federal political candidates in North Carolina.

Component Medical Societies Component (county) medical societies exist across the state to provide a local forum for physician networking and involvement in the community. The component medical societies play a key role in introducing physicians who are new to their communities to the benefits of participation in organized medicine. The NCMS works with component medical societies to conduct programs and to recruit local physicians. The NCMS provides


management services to the Durham-Orange County Medical Society and seeks similar arrangements with other component societies.

American Medical Association The American Medical Association (AMA) provides a national voice for the medical profession. Their advocacy programs include public health initiatives, national legislation, marketplace interventions and strengthening physician leverage in negotiations. The AMA is dedicated to ensuring that the patient-physician bond is kept vital and that physicians retain the freedom to practice the science and art of medicine in its purest form.

NC Physician Advisory Group The North Carolina Physician Advisory Group (NCPAG) is a not-for-profit 501(c)(3) working collaboratively with NC providers to improve the health care system for the Medicaid and uninsured populations. It is supported and has broad representation by major medical specialties and health care providers and it provides advice to the North Carolina Department of Health and Human Services (NCDHHS) on ways to improve the health of the state's vulnerable populations by expanding access to quality, cost-effective health care service.

NC Physicians Health Program The North Carolina Physicians Health Program Group aids physicians and physician assistants with chemical dependency, physical difficulties, mental illness or aging problems. While

impairments that endanger patient safety must be reported to the Medical Board, successful intervention will rehabilitate a career in many instances. NC Medical Society Alliance The North Carolina Medical Society Alliance is a separate 501(C)(3) volunteer organization comprised of physicians’ spouses. Members are involved in proactive community-based initiatives addressing health, social and environmental issues that are educational and preventative in nature.

ADDITIONAL PARTNERS The NCMS has relationships with numerous organizations that are an integral part of advancing our mission. The NCMS shall continue to nurture our relationships with the following organizations.

Medical Mutual Insurance Company of North Carolina The Medical Mutual Group of North Carolina is a physician-owned and physician led organization. Its primary service is providing professional liability insurance to physicians, dentists, other health care providers and provider groups as well as providing them with other insurance products and specialized programs.

NC Institute of Medicine The North Carolina Institute of Medicine is an independent, non-profit organization that serves as a non-political source of health policy analysis and advice in North Carolina. The NC General Assembly chartered it in 1983 to provide balanced, nonpartisan


information on complex and often controversial health issues in our state.

NC Medical Group Managers The North Carolina Medical Group Managers (NCMGM) is a membership organization for medical practice administrators providing educational and networking opportunities. The group was founded in 1971 and represents medical groups statewide. The NCMGM works to improve the operations and viability of medical practices in order to provide the best possible care to patients. Other organizations that play a critical role in helping to achieve the NCMS mission include: NC Hospital Association NC Health Care Facilities Association NC Nurses Association Old North State Medical Society NC Academy of Physician Assistants NC Society of Medical Assistants NC Council of Physician Executives NC Medical Schools and Training

Programs

CONCLUSION The North Carolina Medical Society’s Strategic Plan provides a foundation for carrying out our goals and objectives. The NCMS continues its focus on healthcare quality, access to care, and the patient-physician relationship. The needs of our members will continue to be the driving force behind this endeavor.


Implementation of Strategic Plan Implementation of these priorities will enable the NCMS to shift resources of staff time, money, and leadership activity into priority areas broadly defined as:

Guiding physicians through history’s most transformative time in health care;

Physician advocacy efforts that unify the medical profession across specialties;

Membership growth to strengthen the NCMS organization and its long-term viability.

Focusing on these priorities will require the CEO to realign staff and budget resources. The recommendations below have been identified as potential areas for change that will give the organization the flexibility to reshape resources in order to achieve our overall goals.

(1) AMA Delegation NCMS support for the AMA delegation will continue. Delegates and alternate delegates will be elected, but financial support will be limited to only two alternate delegates beginning January 1, 2012. Additionally, NCMS dues will not be used to fund AMA campaigns; funding for AMA campaigns must come from external sources. Finally, the NCMS staff support for the Southeastern Delegation will be terminated after the AMA A-11 meeting.

(2) NCMS Committees NCMS staff will review the Constitution and Bylaws and make recommendations regarding any changes necessary to replace the traditional committee structure with task forces. Committees required by the Constitution or Bylaws will continue, as necessary, and other deliberative functions would be performed by task forces, appointed by the president. Task forces will be presumed to have a one-year existence, unless required by the bylaws1. The Governance Task Force will be evaluated by the Speaker, Vice Speaker, and Immediate Past President. The effectiveness of all task forces and committees will be reviewed annually by the Board. Staff time previously devoted to perennial committees will be refocused on task forces and other activities of broader benefit to our members. (3) Physician and Practice Services NCMS will work to develop programs for physician practices that generate revenue for, and foster physician engagement in, the NCMS. The NCMS Foundation will be used as an incubator, including possible formation of a subsidiary to manage these services. We will also explore partnership opportunities with Medical Mutual Insurance Company in this area.

1 These Committees include: Communications &

Membership, Constitution & Bylaws, Coordinating Council of Specialty Societies, Evaluation, Finance, Legislation.


(4) Communications Strategy NCMS will consider engagement of outside consultants to develop a comprehensive communications strategy. Research on member and non-member needs will be used to strengthen our media relations function and messaging to doctors and other important constituencies. (5) Physician Leadership NCMS will support and promote the Foundation’s Institute for Physician Leadership, which will replace the nascent NC Physician Institute for Quality Enhancement (NCPIQE). The change will provide more flexibility in fundraising and will provide NC physicians with the leadership skills and knowledge to lead and succeed in the emerging healthcare environment.2 NCMS will also work to identify ways to engage more physicians in governmental processes and attract physicians to serve in the Legislature. (6) Employed Physicians Using research discussed in paragraph six, above, we will increase our focus on the needs of employed physicians. Messaging designed specifically for that groups will be developed to promote programs, advocacy and resources aimed at potential members transitioning from practice ownership to

2 At its October 22, 2010 meeting, the NCMS

Foundation Board of Trustees approved the change from NCPIQE to the NCMS Institute for Physician Leadership.

employment arrangements. Specifically, employment contract and medical staff concerns will be addressed. NCMS will establish a task force to vet these issues. We will also work to improve access to legal services for members. (7) Specialty Society Management Services NCMS will evaluate management services provided to specialty societies within the constraints of available NCMS resources. The objective is to recover 100% of the direct and indirect costs incurred in providing management services to specialties. Recovery of these costs may occur through increased contract fees for services provided or through increased NCMS membership within that specialty. (8) NCMS Finances Continue to expand the NCMS reserves in order to strengthen the organization’s financial stability. This will be a challenging task given the current $5 million renovation project that is occurring. (9) Transformation of Health Care Delivery On the broad issue of affecting changes related to government-driven and private sector reform of the health care system, NCMS will implement the following strategies:

Engage organizations including the NC Hospital Association, the NC Health Care Facilities Association, and other key healthcare provider groups in discussions about ways to work together to improve the healthcare delivery system to ensure better and more efficient care.


Continue to provide leadership in state health information technology (HIT) initiatives and develop programs and tools to assist practices with electronic health record implementation.

Continue to promote the North Carolina Healthcare Exchange (NCHEX) and to provide physicians with a reasonable means to participate in the electronic exchange of health information.

Examine scope of practice conflicts and their effect on collaboration among health professionals.

Facilitate collaborative discussions and efforts between medical specialties to enhance physician leadership and participation in transforming to accountable care delivery.

Actively support the transformation of Community Care of North Carolina (CCNC) into accountable care organizations (ACOs) by facilitating discussions between non-primary care specialties and CCNC and to incorporate all specialties in the CCNC.

(10) Lobbying Budget and Liability Reform NCMS will dedicate additional staff and resources to lobbying the Department of Health and Human Services, with a primary focus on Medicaid. (11) Membership Establish a Task Force to explore membership opportunities specific to employed physician arrangements.

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